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How Does Risankizumab Compare to Fumaric Acid Esters for Plaque Psoriasis?

Significantly more patients achieved ≥90 percent improvement in PASI at week 24 with risankizumab versus FAE

By Dermsquared Editorial Team | January 26, 2022

For moderate-to-severe plaque psoriasis, treatment with the humanized immunoglobulin G1 monoclonal antibody that specifically binds to the p19 subunit of interleukin 23, risankizumab, is superior to fumaric acid ester (FAE) treatment, according to a study published in the January issue of the British Journal of Dermatology .

Diamant Thaçi, M.D., Ph.D., from the University of Lübeck in Germany, and colleagues compared risankizumab to FAE treatment for psoriasis in a phase III randomized trial. Participants with chronic moderate-to-severe plaque psoriasis, who were naive to and candidates for systemic therapy, were randomly assigned to subcutaneous risankizumab 150 mg at weeks 0, 4, and 16 or oral FAEs at increasing doses from 30 to 720 mg daily (60 and 60 patients, respectively).

The researchers found that at 24 weeks, significantly more patients randomly assigned to risankizumab achieved a ≥90 percent improvement in the Psoriasis Area and Severity Index (PASI) than those randomly assigned to FAEs (83.3 and 10.0 percent, respectively). Significantly more patients randomly assigned to risankizumab achieved ≥100 percent improvement in the PASI (50.0 and 5.0 percent, respectively); ≥75 percent improvement in the PASI (98.3 and 33.3 percent, respectively); ≥50 percent improvement in the PASI (100 and 53.3 percent, respectively); and the Static Physician's Global Assessment of clear/almost clear (93.3 and 38.3 percent, respectively). The FAE group had higher rates of gastrointestinal disorders, flushing, lymphopenia, and headache.

"These results support the superiority of risankizumab to FAEs in producing clinically meaningful improvement in the extent and severity of psoriasis over time," the authors write.

Several authors disclosed financial ties to AbbVie, which manufactures risankizumab and funded the study.

Abstract/Full Text

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